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October 31, 2000

Transplants

Question from Chicago, Illinois, USA:

I have type 1 diabetes. There is quite a bit of talk these days about the use of islet cell grafting and pancreas transplants as a cure for diabetes. Even when successful, the recipients of this type of therapy must take immunosuppressant drugs for the rest of their lives. What is the risk of cancer and opportunistic infection, which I know is increased when taking these drugs? Is it worth trading diabetes for possible cancer?

Answer:

You are correct to worry about future potential risks of cancer and other overwhelming infections whenever anyone uses immunosuppressive medications. We are hopeful that the latest protocol from Canada will decrease such risks. In these trials, the total medication burden is lowered by being able to use less toxic medications in lower than usual doses, and prednisone-like medications are not being used. We don’t really know even short term risk figures. however, since one must wait at least five to ten (or longer) to fully understand what the risks are. Good scientists include such estimates and keep extremely careful records of all such patients for many years to try to answer these questions and then balance out the benefits expected vs the risks expected.

SB